CS - Pale mucous membranes Flashcards
What do ghost cells indicate on blood smear?
intravascular haemolysis
What do spherocytes indicate?
extravascular haemolysis
Describe haemolysis in IMHA
extravascular and intravascular components
Cause -rubricytosis
- marked regenerative process (anaemia)
- BM hypoxia may also contribute
Causes - secondary IMHA
- infection
- neoplasia
- drug exposure
- dx of primary IMHA is one of exclsuion
What is Evans’ syndrome?
When IMTP occurs concurrently with IMHA
Side effects -corticosteroids
thirst urination, increased appetite and weight gain, panting, mm weak, increased ifxn susceptibility d/t suppressed I.S.
Why is azathioprine used with corticosteroids nowadays in tx of IMHA?
so that lower dose corticosteroids can be used, BUT risk of acute pancreatitis
CS - acute pancreatitis
vomiting, marked cranial abdominal discomfort, inappetence, lethargy, then canine pancreatic lipase for biochem evidence
How does human IVIG work with IMHA tx?
occupies Fc –R on macrophages preventing opsonisation of IgG coated RBCs, controversial efficacy and not widely available in vet med.
Why is risk of thromboembolism high in primary IMHA?
d/t release of pro-coagulant molecules, low dose aspirin, heparin often to prevent thrombi, dose to individual
Prognosis - IMHA
- fair to guarded,
- roughly 30-50% animals survive 1 y after initial tx,
- highest mortality in first 2 weeks,
- anaemia is not usually fatal but the complications (thromboembolic effects),
- dogs usually do well long term if cope well with acute tx, generally life-long tx.
- Usually have excellent QoL.
What are codocytes?
- mexican hat/ target cells
- linked with Fe deficiency
Why do you tend to have low Ca with low protein?
d/t fact that Ca is carried by albumin so low albumin means low Ca. To determine if there is a genuine low Ca, run a test for free Ca concentration.
List examples of SI cancer
intestinal adenocarcinoma, leiomyoma, leiomyosarcoma, lymphoma, MCT, GIT stromal tumour (GIST), carcinoid and rarely plasma cell tumour or rarely HAS.
T/F: anaemic patients (low PCV) will have a higher absolute reticulocyte count than normal patient
True
Intestinal adenocarcinoma -signlment
intestinal adenocarcinoma, leiomyoma, leiomyosarcoma, lymphoma, MCT, GIT stromal tumour (GIST), carcinoid and rarely plasma cell tumour or rarely HAS.
Main CS - intestinal adenocarcinoma
wt loss and vomiting d/t intestinal obstruction
Location - intestinal adenocarcinoma
can affect stomach, SI, LI and rectum
Tx - intestinal adenocarcinoma
- complete sx excision if possible (midline laparotomy)
- chemo usually unsuccessful
- radiotherapy not possible d/t local tissue intolerance
Prognosis - intestinal adenocarcinoma
- good if complete sx excsion possible
- mets to local LNs common by time of dx
- re-examine q3mo
- Gastric neoplasm: MST is 2 months
- Intestinal neoplasm: MST is 10 months
- Gastric: high risk complications
Types - MCT
unlike cutaneous form is relatively uncommon (i.e. GIT type), haematopoietic and GIT types
Tx and Px - intestinal MCT
sx remove whole spleen or GIT affected. poor prognosis within 2 months first admission, no chemo as short MST, NSAIDs to reduce inflammation, special diet to reduce irritation of GIT
Describe intestinal lymphoma
alimentary form arises form mesenteric LN
Tx - intestinal lymphoma
sx, radiotherapy and chemo (COP),
Px - intestinal lymphoma
no tx 6-8 wks, corticosteroids 3 mo, chemo 6-12 mo. Dogs generally do poorly cats well. Determine if high or low grade before offering prognosis. BC type gets a better response to certain chemo protocols than TC types. sc can be used alongside chemo for focal masses
T/F: GIT neoplasms tend to be malignant
Ture
How common are GIT neoplasms?
- uncommon in cats and dogs
- Gastric tumours
Define leiomyosarcoma
malignant SMC tumour
Tx - leiomyosarcoma
- Surgery – BEST CHOICE - complete excision may not be possible
- Chemotherapy – anecdotal. Possible choices include doxorubicin, platinum agents, and ifosfamide.
Px - leiomyosarcoma
Study survival times range from 0 to 47 months, with an approximate MST of 12
21.3months MST if initial post-op period survived (Cohen et al 2003)
Dogs with histologically documented metastasis had similar survival time
Tx - aplastic anaemia d/t hyperoestrogenism associated with sertoli cell tumour
- Initial symptomatic – stabilise for blood dyscrasia, normalise [RBC] with PRP/ WB
- Standard tx – castration + scrotal ablation
- Others – Abx, hemantinics, blood products
Px - aplastic anaemia d/t hyperoestrogenism associated with sertoli cell tumour
better for scrotal tissue (as in this case), oestrogenic signs resolve 1-2 mo after castration, DM suppression can be chronic
Reasons for tx failure with sertoli cell tumour - induced hyperoestrogenism
metastatic dz, failure to recover form blood dyscrasia (i.e. the aplastic anaemia), death d/t haemorrhage form thrombocytopaenia/ anaemiarf
